| NPI | 1780167452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN192153) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: GA RN192153) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2019-01-12 |