| NPI | 1063994523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN220470) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN220470) |
| 363LF0000X Nurse Practitioner Family (Licence: GA F07180061) | |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2018-09-13 |