NPI | 1669928388 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20453) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN165924) |
Enumeration Date | 2016-09-01 |
Last Update Date | 2024-05-06 |