| NPI | 1962894436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7723) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN188190) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2020-03-30 |