| NPI | 1174102081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN295051) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 24953) |
| Enumeration Date | 2021-04-07 |
| Last Update Date | 2021-09-24 |