| NPI | 1457999732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN301999) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN301999) |
| 163W00000X Registered Nurse (Licence: NY 735082) | |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2021-09-16 |