| NPI | 1063932101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9456459) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN100171) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2025-09-26 |