| NPI | 1053839167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD AC003174) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN202640) |
| Enumeration Date | 2017-09-08 |
| Last Update Date | 2025-01-13 |