| NPI | 1205453487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN243854) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN243854) |
| 363L00000X Nurse Practitioner (Licence: GA RN243854) | |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2024-08-20 |