| NPI | 1053807560 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN235646)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN235646)  | 
| Enumeration Date | 2018-07-09 | 
| Last Update Date | 2022-01-27 |