| NPI | 1407411424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN287809) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 673403) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: NY 309415) | |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2020-07-21 |