| NPI | 1912559980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11009774) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN231326) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2021-09-17 |