| NPI | 1124677893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN293292) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 187027) |
| 163WM0705X Registered Nurse Medical-Surgical (Licence: TN 187027) | |
| 363L00000X Nurse Practitioner (Licence: TN 93502) | |
| 363L00000X Nurse Practitioner (Licence: GA RN293292) | |
| 363LF0000X Nurse Practitioner Family (Licence: TN 93502) | |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2021-06-03 |