| NPI | 1962030809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 24751) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN262574) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2022-12-06 |