| NPI | 1508928201 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 159225) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN159225) | 
| Enumeration Date | 2006-12-16 | 
| Last Update Date | 2022-03-17 |