NPI | 1831631449 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003417) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN208626) |
Enumeration Date | 2016-11-14 |
Last Update Date | 2021-01-14 |