| NPI | 1699133256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA 102064) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA F0216291) |
| Enumeration Date | 2016-02-10 |
| Last Update Date | 2021-09-08 |