NPI | 1669818043 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 17329) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN230297) |
363LF0000X Nurse Practitioner, Family (Licence: TX 2354) | |
Enumeration Date | 2013-05-13 |
Last Update Date | 2022-09-23 |