NPI | 1588015473 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN217213) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN217213) |
Enumeration Date | 2016-06-22 |
Last Update Date | 2023-08-17 |