| NPI | 1174988828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 160707) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN250202) |
| 363L00000X Nurse Practitioner (Licence: GA RN250202) | |
| Enumeration Date | 2015-12-23 |
| Last Update Date | 2021-04-27 |