NPI | 1497424543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN175364) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN175364) |
Enumeration Date | 2021-09-12 |
Last Update Date | 2022-03-19 |