NPI | 1811071756 |
---|---|
Former Name | SONJA LYNN HENDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LC0200X Nurse Practitioner, Critical Care Medicine (Licence: GA RN148590 NP) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN148590) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2020-10-16 |