| NPI | 1407832785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN273572) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 263494) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2021-03-24 |