| NPI | 1053988691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN170055) |
| Additional Taxonomies | 163WS0121X Registered Nurse, Plastic Surgery (Licence: GA RN170055) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2022-04-05 |