| NPI | 1548965643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN204086) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN204086) |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2023-10-13 |