| NPI | 1063927101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-145440) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN255890) |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2020-07-27 |