| NPI | 1104259324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 17820) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN232965) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2022-09-02 |