| NPI | 1457604993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN185907) |
| Additional Taxonomies | 2086S0129X Surgery, Vascular Surgery (Licence: GA RN185907) |
| 363LF0000X Nurse Practitioner, Family (Licence: WV 67888) | |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2024-02-21 |