| NPI | 1558922096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN298353) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 24053) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NC AUST-OPEG30) | |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2026-01-29 |