| NPI | 1710517941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN256719) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN256719) |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2024-10-02 |