| NPI | 1912468521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN219626) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11001573) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-03-27 |