| NPI | 1558693119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN260831) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: VA 0001219620) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN260831) | |
| Enumeration Date | 2010-02-08 |
| Last Update Date | 2019-04-16 |