| NPI | 1053956045 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN185141) | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CT 10235) | 
| Enumeration Date | 2019-11-13 | 
| Last Update Date | 2024-07-19 |