| NPI | 1558979229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 347659) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN224714) |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2023-10-04 |