| NPI | 1548682297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012589) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN164158) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2021-06-14 |