| NPI | 1255983466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11007645) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN242807) |
| Enumeration Date | 2019-07-09 |
| Last Update Date | 2023-03-27 |