| NPI | 1740898782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN 220231) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN301639) |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2021-05-11 |