| NPI | 1235680398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5009110) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 256300) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2024-08-06 |