| NPI | 1407542087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RNN316622) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN316622) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2024-10-23 |