| NPI | 1669869467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5009506) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN219215) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2020-09-09 |