| NPI | 1588813307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN218122) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 280040) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2022-03-18 |