| NPI | 1639687858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 21590) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN272112) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2022-11-02 |