| NPI | 1194077875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN137657) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 1004077) |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 1-082574) | |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2025-05-07 |