| NPI | 1649611104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA rn201612) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 201612) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2020-07-21 |