| NPI | 1588064596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201703946NP-PP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN194301) |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2021-12-10 |