| NPI | 1912559980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 1912559980) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11009774) |
| 363L00000X Nurse Practitioner (Licence: GA RN231326) | |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2025-02-03 |