NPI | 1609373919 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN150603) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 219654) |
Enumeration Date | 2018-04-12 |
Last Update Date | 2024-10-31 |