| NPI | 1891348256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN164335) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 23050) |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2019-09-03 |