| NPI | 1205206893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN307928) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F344400) |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2022-01-31 |