| NPI | 1801158761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008123) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 220231) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN222372) | |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2021-10-28 |