| NPI | 1851546568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 154701) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 3705) |
| Enumeration Date | 2008-11-21 |
| Last Update Date | 2020-06-23 |