| NPI | 1124643614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN296735) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 213745) |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2022-05-02 |