| NPI | 1477815488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9411986) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 16928) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA 208361) | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2020-05-06 |