| NPI | 1912436460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN275883) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174529) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-21 |