| NPI | 1861967564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN281463) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11013778) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2024-11-07 |