| NPI | 1376914184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN285678) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP015375) |
| 163W00000X Registered Nurse (Licence: PA RN587335) | |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2021-12-23 |