| NPI | 1477635290 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN102372) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN102372) | 
| Enumeration Date | 2006-10-20 | 
| Last Update Date | 2023-06-21 |