| NPI | 1639414188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-111962) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN177275) |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2018-02-14 |