| NPI | 1245671890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN168664) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 168664) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2021-04-27 |