| NPI | 1548033624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN290464) |
| Additional Taxonomies | 2084P0805X (Licence: GA 290464) |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2024-04-02 |