NPI | 1609293463 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-133190) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN187508) |
Enumeration Date | 2014-03-18 |
Last Update Date | 2025-03-31 |