NPI | 1942362033 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA APRN272682) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 111177) |
363LF0000X Nurse Practitioner, Family (Licence: SC 22581) | |
Enumeration Date | 2006-12-14 |
Last Update Date | 2022-09-27 |