| NPI | 1902205057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN186355) |
| Additional Taxonomies | 163WE0003X Registered Nurse Emergency (Licence: GA RN186355) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2018-11-15 |