| NPI | 1619334562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN139658) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN139658) |
| 208VP0000X (Licence: GA RN139658) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN139658) | |
| Enumeration Date | 2016-01-23 |
| Last Update Date | 2021-02-26 |