| NPI | 1770005084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 0324206) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 112245) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2020-09-11 |