| NPI | 1659779809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN269126) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19215) |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2018-03-17 |