| NPI | 1689924474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 190461) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA 190461) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2021-12-14 |