| NPI | 1013392570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN161369) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN MO3856878) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2018-08-06 |