| NPI | 1669005880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 12635) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN281026) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN281026) | |
| Enumeration Date | 2020-02-17 |
| Last Update Date | 2025-05-13 |