| NPI | 1972259786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN311997) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2019035196) |
| 163W00000X Registered Nurse (Licence: IL 041455812) | |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2022-08-24 |