| NPI | 1992053367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 16929) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN202739) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2020-06-14 |