| NPI | 1174680177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2374174) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN133358) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2023-01-23 |