| NPI | 1457986598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN118734) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RB118734) |
| 363L00000X Nurse Practitioner (Licence: GA RN11734) | |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2021-06-19 |