NPI | 1578160560 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN194221) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA F07191756) |
Enumeration Date | 2020-10-03 |
Last Update Date | 2020-12-08 |