| NPI | 1962952028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN204599) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ RN200711) |
| 207Q00000X Family Medicine (Licence: TN 35309) | |
| 207Q00000X Family Medicine (Licence: TX 1207204) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95008153) | |
| 207Q00000X Family Medicine (Licence: FL 11039368) | |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2025-12-04 |