NPI | 1689119299 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN224032) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN224032) |
Enumeration Date | 2017-01-05 |
Last Update Date | 2019-10-02 |