| NPI | 1003208729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 19326) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN288707) |
| 363LF0000X Nurse Practitioner Family (Licence: SC 19326) | |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2022-11-08 |