| NPI | 1659845394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5013510) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN28206) |
| 363LF0000X Nurse Practitioner Family (Licence: SC 22616) | |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2020-09-09 |