| NPI | 1679232177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 310870) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11016474) |
| Enumeration Date | 2021-12-12 |
| Last Update Date | 2022-06-01 |