| NPI | 1831942002 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN334094) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS 906611) |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 3-001664) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP001904) | |
| Enumeration Date | 2024-04-08 |
| Last Update Date | 2025-02-06 |