| NPI | 1831631449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11003417) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN208626) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2021-01-14 |