| NPI | 1528367406 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5011780) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN213047) |
| 163W00000X Registered Nurse (Licence: GA RN213047) | |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2022-09-12 |