NPI | 1578870457 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN211306) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9234658) |
Enumeration Date | 2010-09-13 |
Last Update Date | 2021-03-31 |