| NPI | 1790137214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NV 820245) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN223083) |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2020-07-20 |