| NPI | 1154881969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014947) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN253137) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2022-04-28 |