| NPI | 1508493974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN298325) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN298325) |
| 163W00000X Registered Nurse (Licence: NY 743547) | |
| 363L00000X Nurse Practitioner (Licence: NY 309735) | |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-11-23 |