| NPI | 1972167740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP001987) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002064) |
| Enumeration Date | 2019-04-27 |
| Last Update Date | 2024-12-17 |