NPI | 1629582135 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN267688) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: AL 1-144900) |
Enumeration Date | 2017-11-20 |
Last Update Date | 2025-09-16 |