NPI | 1558735241 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 19869) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5021532) |
363LF0000X Nurse Practitioner, Family (Licence: FL APRN11037196) | |
363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP003104) | |
Enumeration Date | 2015-11-18 |
Last Update Date | 2025-07-31 |