| NPI | 1659630945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN180140) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH EL31078) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2024-06-19 |