| NPI | 1568136505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN173191) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN173191) |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2022-02-01 |