| NPI | 1649864117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN204507) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN204507) |
| 363L00000X Nurse Practitioner (Licence: GA RN204507) | |
| Enumeration Date | 2021-02-25 |
| Last Update Date | 2022-10-19 |