| NPI | 1427698836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA AG12190079) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11025470) |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2023-06-01 |