| NPI | 1255819298 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN299005) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024186196) | 
| Enumeration Date | 2018-08-01 | 
| Last Update Date | 2024-12-19 |