| NPI | 1811375173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 168411) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN168411) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2021-08-06 |