NPI | 1659720456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-106332) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN174428) |
Enumeration Date | 2016-06-13 |
Last Update Date | 2016-09-08 |