| NPI | 1639803604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN264609) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN264609) |
| 363L00000X Nurse Practitioner (Licence: GA RN264609) | |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2024-04-19 |