| NPI | 1952684219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: AL 1-124835) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN195459) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2019-03-25 |