| NPI | 1760449649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 18084) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN219030) |
| 363L00000X Nurse Practitioner (Licence: PA SP006623B) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2019-02-26 |