| NPI | 1104170174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN118507) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 104350) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2022-08-05 |