| NPI | 1740749209 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5017725) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN261675) |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2023-03-01 |