| NPI | 1962952028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN204599) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95008153) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2018-06-19 |