| NPI | 1033728647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN249003) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2344455) |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2023-07-10 |