| NPI | 1235806258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN305783) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA RN305783) |
| 363LF0000X Nurse Practitioner Family (Licence: OH APRN.CNP.0027932) | |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2021-11-16 |