| NPI | 1275802365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN221058) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 16334) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2022-07-17 |