| NPI | 1932552890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20218) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN201619) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2020-05-15 |