| NPI | 1053959783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN081737) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: GA RN081737) |
| Enumeration Date | 2019-12-12 |
| Last Update Date | 2020-10-15 |