NPI | 1558979229 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347659) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN224714) |
Enumeration Date | 2020-07-20 |
Last Update Date | 2023-10-04 |