| NPI | 1720739543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 264319-30) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN297865) |
| Enumeration Date | 2022-01-13 |
| Last Update Date | 2023-04-21 |