NPI | 1902209505 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008529) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN205991) |
Enumeration Date | 2014-09-27 |
Last Update Date | 2016-05-12 |