| NPI | 1982168837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN247907) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN247907) |
| 163W00000X Registered Nurse (Licence: TN 209858) | |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2019-01-24 |