| NPI | 1407409469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN204663) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 47307) |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2021-03-09 |