| NPI | 1356804561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN240343) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN240343) |
| Enumeration Date | 2019-04-13 |
| Last Update Date | 2024-05-15 |