NPI | 1326633942 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN252336) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 252336) |
363LF0000X Nurse Practitioner, Family (Licence: UT 13107426-4405) | |
Enumeration Date | 2021-03-05 |
Last Update Date | 2025-01-21 |