NPI | 1417344813 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN253879) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 507581) |
363LF0000X Nurse Practitioner, Family (Licence: TX AP127593) | |
Enumeration Date | 2015-04-23 |
Last Update Date | 2024-11-08 |