| NPI | 1134748320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN212745) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN212745) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2021-10-22 |