| NPI | 1104410042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ 257365) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN290079) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-06-14 |