| NPI | 1205340080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN301375) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 355099) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209016926) | |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2024-10-14 |