| NPI | 1710379730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN262737) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 33339508) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC001753) | |
| Enumeration Date | 2015-02-27 |
| Last Update Date | 2019-08-16 |