NPI | 1669606950 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN169079) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 3838) |
Enumeration Date | 2009-05-14 |
Last Update Date | 2022-07-21 |