| NPI | 1770723579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN195575) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 3873) |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2023-06-12 |