NPI | 1811375173 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 168411) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN168411) |
Enumeration Date | 2015-05-07 |
Last Update Date | 2021-08-06 |