NPI | 1508870460 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN235429) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IN 71000462) |
Enumeration Date | 2006-07-28 |
Last Update Date | 2019-10-25 |