| NPI | 1861082554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA NCO-000001) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN239348) |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2021-06-18 |