| NPI | 1720618630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 26116) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 291807) |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2020-02-24 |