NPI | 1851780688 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-126175) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN218432) |
Enumeration Date | 2015-01-16 |
Last Update Date | 2019-07-18 |