| NPI | 1790284222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN243256) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 902518) |
| Enumeration Date | 2018-02-10 |
| Last Update Date | 2024-03-19 |