| NPI | 1609156959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN195066) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RN19566) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2020-06-23 |