| NPI | 1790408953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN306484) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 26471) |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2023-08-31 |