NPI | 1346587573 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN121290) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN121290) |
Enumeration Date | 2013-01-08 |
Last Update Date | 2018-01-24 |