NPI | 1447586086 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 195045) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5004991) |
363LF0000X Nurse Practitioner, Family (Licence: SC 4041) | |
Enumeration Date | 2009-11-01 |
Last Update Date | 2020-07-23 |