| NPI | 1639727159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN316942) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9467135) |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2023-08-03 |