| NPI | 1679136402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN234910) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-171574) |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2019-04-17 |