| NPI | 1629471669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9486522) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN203316) |
| Enumeration Date | 2014-10-05 |
| Last Update Date | 2018-12-17 |