| NPI | 1689197105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC POWE-M074R3) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN232638) |
| 163W00000X Registered Nurse (Licence: NC 292929) | |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |