| NPI | 1003179946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN191947) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA rn191947) |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2018-07-17 |