| NPI | 1164072591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN289947) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA 226773) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2022-09-23 |