| NPI | 1992302616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN323164) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 196648) |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2024-04-30 |