| NPI | 1124330030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25365) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN165086) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2021-11-18 |