| NPI | 1902135650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN307198) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F336082) |
| 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9397621) | |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2022-01-03 |