| NPI | 1770963779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9397202) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN126817) |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2024-03-21 |