| NPI | 1164989265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95027061) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN265853) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN265853) | |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2024-02-27 |