NPI | 1548682297 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012589) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN164158) |
Enumeration Date | 2014-01-15 |
Last Update Date | 2021-06-14 |