| NPI | 1073887659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-123496) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN191802) |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2023-02-06 |