NPI | 1578071387 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002581) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN257152) |
Enumeration Date | 2018-01-15 |
Last Update Date | 2021-04-12 |