NPI | 1417145939 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005997) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN093611) |
Enumeration Date | 2007-10-10 |
Last Update Date | 2015-03-17 |