| NPI | 1063974954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN266976) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN266976) |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2023-03-15 |