| NPI | 1417396904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC SC19037) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN121215) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN228108) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2020-12-18 |