| NPI | 1609406784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 227372) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 21864) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 227372) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: GA 227372) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA 227372) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 21864) | |
| Enumeration Date | 2020-01-17 |
| Last Update Date | 2020-01-17 |