| NPI | 1568153971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN175213) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL 11025244) |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2024-05-20 |