| NPI | 1265729396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 23523) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN178157) |
| Enumeration Date | 2011-07-10 |
| Last Update Date | 2021-08-12 |