| NPI | 1629608492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN281201) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA F01201189) |
| 363LF0000X Nurse Practitioner Family (Licence: GA RN281201) | |
| Enumeration Date | 2020-01-21 |
| Last Update Date | 2021-05-15 |