| NPI | 1043698574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN224476) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19403) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024172448) | |
| Enumeration Date | 2015-05-17 |
| Last Update Date | 2019-10-11 |