| NPI | 1790194314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN246307) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-129486) |
| Enumeration Date | 2014-08-07 |
| Last Update Date | 2015-10-13 |