NPI | 1629541677 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN235670) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN235670) |
Enumeration Date | 2019-01-02 |
Last Update Date | 2023-09-07 |