NPI | 1780128983 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN227890) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 258497) |
363LF0000X Nurse Practitioner, Family (Licence: NC 5011825) | |
Enumeration Date | 2016-12-07 |
Last Update Date | 2020-07-08 |