NPI | 1538782602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN211400) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN259683) |
Enumeration Date | 2020-05-24 |
Last Update Date | 2025-01-21 |