| NPI | 1629667001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN240072) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: GA RN240072) |
| Enumeration Date | 2021-01-11 |
| Last Update Date | 2021-11-02 |