| NPI | 1073122198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN216188) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA 216188) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2024-10-07 |