NPI | 1659516011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ 251456) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN214425) |
Enumeration Date | 2008-12-12 |
Last Update Date | 2022-09-02 |