NPI | 1649272691 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA R039856) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC R00079381) |
Enumeration Date | 2005-06-02 |
Last Update Date | 2014-08-07 |