| NPI | 1780936310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN204954) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA F0612131) |
| Enumeration Date | 2012-10-05 |
| Last Update Date | 2022-09-14 |