| NPI | 1902276785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 20507) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN RN129399) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN165766) | |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-19 |