NPI | 1811668197 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN198802) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017064) |
Enumeration Date | 2021-09-25 |
Last Update Date | 2024-10-01 |