| NPI | 1639796196 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: GA F10190607) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 1639796196) | 
| Enumeration Date | 2020-07-01 | 
| Last Update Date | 2020-09-22 |