NPI | 1306245576 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN268871) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP126209) |
363LF0000X Nurse Practitioner, Family (Licence: TN AP0000025068) | |
Enumeration Date | 2014-08-13 |
Last Update Date | 2024-10-28 |