| NPI | 1275698284 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN308026) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV 834163) | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308061) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 95010236) | |
| Enumeration Date | 2006-12-27 | 
| Last Update Date | 2025-07-10 |