NPI | 1811454317 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 23859) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN239472) |
Enumeration Date | 2019-02-21 |
Last Update Date | 2021-12-03 |