| NPI | 1780932939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 164926) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 26635) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2022-02-18 |