NPI | 1750764932 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN068065) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: GA RN068065) |
Enumeration Date | 2015-07-07 |
Last Update Date | 2020-10-21 |