| NPI | 1104608215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN292748) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD004975) |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2024-09-19 |