| NPI | 1346880739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN299320) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-107679) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2021-02-16 |