| NPI | 1861991820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN196816) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: OH 022647) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-06-20 |