NPI | 1760965198 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN216436) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP139796) |
Enumeration Date | 2018-09-11 |
Last Update Date | 2024-05-16 |