| NPI | 1528580636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN207961) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A143646) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2021-06-08 |