| NPI | 1649789041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN152964) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 21117) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2020-09-17 |