| NPI | 1720352677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN159390) |
| Additional Taxonomies | 364SA2200X Clinical Nurse Specialist Adult Health (Licence: GA RN159390) |
| Enumeration Date | 2012-02-23 |
| Last Update Date | 2012-02-23 |