NPI | 1356721179 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19515) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN248833) |
Enumeration Date | 2015-06-06 |
Last Update Date | 2022-07-21 |