| NPI | 1376993519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN192902) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 192602) |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2019-04-03 |