| NPI | 1053793919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AK 164848) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 250648) |
| 363L00000X Nurse Practitioner (Licence: GA RN280377) | |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2023-01-24 |