| NPI | 1407449663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 24873) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN292014) |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2022-02-18 |