NPI | 1962030809 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24751) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN262574) |
Enumeration Date | 2020-03-27 |
Last Update Date | 2024-11-25 |