| NPI | 1104582931 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: GA GAA-NP000359) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA NP000359) | 
| Enumeration Date | 2021-11-16 | 
| Last Update Date | 2025-10-09 |