NPI | 1669209052 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN288325) |
Additional Taxonomies | 163WC1500X Registered Nurse, Community Health (Licence: GA RN288325) |
261QH0100X Clinic/Center, Health Services (Licence: GA RN288325) | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA RN288325) | |
Enumeration Date | 2024-09-18 |
Last Update Date | 2024-09-18 |