| NPI | 1831617042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5012431) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 317694) |
| 363L00000X Nurse Practitioner (Licence: GA RN207146) | |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2020-05-04 |