| NPI | 1245580414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN158173) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA RN158173) |
| 363L00000X Nurse Practitioner (Licence: GA RN158173) | |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2024-08-07 |