NPI | 1679165716 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN231948) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN231948) |
Enumeration Date | 2021-02-10 |
Last Update Date | 2024-01-30 |