NPI | 1639699531 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN181539) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 20587) |
Enumeration Date | 2017-06-21 |
Last Update Date | 2021-07-22 |