| NPI | 1619518792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN226155) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA rn226155) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2019-11-22 |