| NPI | 1861932113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 223046) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 22296) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |