NPI | 1619511672 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001226) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP004049) |
Enumeration Date | 2019-11-03 |
Last Update Date | 2025-09-29 |