| NPI | 1316407307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 25681) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 240601) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2024-06-13 |