NPI | 1528653920 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11033288) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN277747) |
363LF0000X Nurse Practitioner, Family (Licence: NY 355423) | |
363LF0000X Nurse Practitioner, Family (Licence: GA RN277747) | |
Enumeration Date | 2021-03-08 |
Last Update Date | 2025-01-07 |