| NPI | 1205416195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN207053) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN207053) |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2022-10-06 |