NPI | 1376098731 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN217424) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN217424) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN217424) | |
Enumeration Date | 2016-08-15 |
Last Update Date | 2017-02-18 |