| NPI | 1811668197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5017064) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11020519) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP000402) | |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2022-10-20 |