| NPI | 1659086296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN247679) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 32976) |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2024-10-21 |