| NPI | 1972125334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN294344) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 894459) |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-06-05 |