| NPI | 1578913646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN211008) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-121795) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2020-08-20 |