NPI | 1659779809 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN269126) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19215) |
Enumeration Date | 2014-12-19 |
Last Update Date | 2018-03-17 |