| NPI | 1801858527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN112762) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN112762) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA 0340729 22) | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2008-07-29 |