| NPI | 1386036895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA F03170428) |
| Additional Taxonomies | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA PCH008421) |
| Enumeration Date | 2015-02-21 |
| Last Update Date | 2017-04-03 |