| NPI | 1871040394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 170589) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9396881) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2018-03-17 |