| NPI | 1306884374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN124581) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4450) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2021-05-04 |