| NPI | 1811417454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN277117) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 063749-21) |
| 163W00000X Registered Nurse (Licence: MA 063749-21) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NH 063749-23) | |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2023-02-21 |