| NPI | 1396101796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN206076) |
| Additional Taxonomies | 261QP0904X Clinic/Center, Public Health, Federal (Licence: GA RN206076) |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2020-10-20 |