| NPI | 1487292694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN225738) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN225738) |
| 363L00000X Nurse Practitioner (Licence: GA RN225738) | |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2024-05-08 |