| NPI | 1154749356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN260862) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704272706) |
| 163W00000X Registered Nurse (Licence: GA RN260862) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2024-03-05 |