| NPI | 1629440110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 334341) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9296278) |
| Enumeration Date | 2015-10-23 |
| Last Update Date | 2025-10-11 |