| NPI | 1821257122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 17712) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN289949) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 304416) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2023-02-07 |