| NPI | 1205478351 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 169538) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN169538) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2021-09-23 |