| NPI | 1003394909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN239908) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5010907) |
| 363LF0000X Nurse Practitioner Family (Licence: GA RN239908) | |
| Enumeration Date | 2018-08-02 |
| Last Update Date | 2023-06-20 |