| NPI | 1619428653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN209029) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 28667) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2024-05-14 |