| NPI | 1275870164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 133612) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 133612) |
| 363L00000X Nurse Practitioner (Licence: GA 133612) | |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2021-04-15 |