| NPI | 1164051470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN209055) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 346435) |
| Enumeration Date | 2020-04-07 |
| Last Update Date | 2021-06-04 |