| NPI | 1124503511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002497) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 186823) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2021-11-09 |