| NPI | 1639552490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 901440) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN232343) |
| Enumeration Date | 2015-06-29 |
| Last Update Date | 2018-08-08 |