| NPI | 1790210458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 22602) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN270978) |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2019-11-15 |