| NPI | 1104436484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN212221) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA RN212221) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2021-02-15 |