| NPI | 1811454317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 23859) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN239472) |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2021-12-03 |