| NPI | 1174149199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 346935) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN281610) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2021-08-21 |