| NPI | 1679982805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN198306) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 198306) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2018-08-17 |