NPI | 1811134133 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN261865) |
Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: GA F04180236) |
261QP2300X Clinic/Center, Primary Care (Licence: KY 2040478) | |
363L00000X Nurse Practitioner (Licence: CO 0001176) | |
363L00000X Nurse Practitioner (Licence: GA F04180236) | |
363L00000X Nurse Practitioner (Licence: FL 11015245) | |
363LF0000X Nurse Practitioner, Family (Licence: VA 0024184041) | |
Enumeration Date | 2009-01-08 |
Last Update Date | 2022-10-28 |