NPI | 1639638349 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN227954) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 227954) |
Enumeration Date | 2019-03-13 |
Last Update Date | 2024-02-23 |