NPI | 1689197105 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC POWE-M074R3) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN232638) |
163W00000X Registered Nurse (Licence: NC 292929) | |
Enumeration Date | 2017-07-18 |
Last Update Date | 2017-07-18 |