| NPI | 1386135663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN212285) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: GA RN212285) |
| 363LF0000X Nurse Practitioner Family (Licence: GA RN212285) | |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2020-05-12 |