| NPI | 1912209214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 170568) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 170568) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5005259) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024182411) | |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2024-05-03 |