| NPI | 1942074729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 330672) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 296675) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2024-07-10 |