NPI | 1902402118 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN220192) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 220192) |
Enumeration Date | 2020-12-11 |
Last Update Date | 2024-10-22 |