| NPI | 1942362033 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA APRN272682) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 111177) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 22581) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2022-09-27 |