| NPI | 1508331505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN202374) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 24762) |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2019-04-05 |