| NPI | 1821305293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN310457) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 264189) |
| 363L00000X Nurse Practitioner (Licence: NY 431140) | |
| 363L00000X Nurse Practitioner (Licence: FL APRN11005866) | |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2022-04-13 |