| NPI | 1104385087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: GA RN249789) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN249789) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2022-01-12 |