NPI | 1790222727 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN191668) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN191668) |
Enumeration Date | 2017-01-29 |
Last Update Date | 2019-08-28 |