| NPI | 1295369957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000030466) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN229133) |
| Enumeration Date | 2020-03-02 |
| Last Update Date | 2021-11-16 |