| NPI | 1871050450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN284419) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN284419) |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2019-04-06 |