| NPI | 1144653502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN266075) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 15955) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2025-08-08 |