| NPI | 1902336761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN215861) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9456219) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2021-04-15 |