| NPI | 1407591936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 26355) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN275649) |
| Enumeration Date | 2022-04-29 |
| Last Update Date | 2022-10-25 |