NPI | 1568020469 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 26152) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024178664) |
363LF0000X Nurse Practitioner, Family (Licence: GA RN263038) | |
363LF0000X Nurse Practitioner, Family (Licence: SC 22903) | |
Enumeration Date | 2019-06-05 |
Last Update Date | 2021-03-01 |