NPI | 1598224081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN226765) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 226765) |
261QH0100X Clinic/Center, Health Services | |
Enumeration Date | 2019-03-14 |
Last Update Date | 2022-01-03 |