| NPI | 1053807131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA RN273077) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN273077) |
| 163W00000X Registered Nurse (Licence: HI 82220) | |
| 363LF0000X Nurse Practitioner Family (Licence: GA RN273077) | |
| 363LF0000X Nurse Practitioner Family (Licence: KY 3012842) | |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2022-01-03 |