| NPI | 1912905464 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN027354) | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: GA RN027354) | 
| Enumeration Date | 2005-07-08 | 
| Last Update Date | 2024-08-19 |