| NPI | 1194498634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA NP000357) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 254429) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2021-10-25 |