NPI | 1780932939 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 164926) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 26635) |
Enumeration Date | 2012-08-20 |
Last Update Date | 2024-11-22 |