| NPI | 1891279063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 225028) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9495686) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2023-02-10 |