| NPI | 1811460975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP000111) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2019000937) |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2021-03-25 |