| NPI | 1104229657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 31011) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN241067) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2025-11-22 |