| NPI | 1255941571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24108) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN290237) |
| Enumeration Date | 2020-08-01 |
| Last Update Date | 2020-12-01 |