| NPI | 1104171446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN184069) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: GA RN184069) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2025-09-05 |