| NPI | 1306250550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 22349) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN155479) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2021-03-23 |