| NPI | 1164040341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24036) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 24036) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN264668) | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2022-11-02 |