NPI | 1477804839 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN317861) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3007672) |
Enumeration Date | 2012-09-26 |
Last Update Date | 2023-03-07 |