NPI | 1780112789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN301836) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F341113-1) |
Enumeration Date | 2017-06-02 |
Last Update Date | 2024-08-09 |