| NPI | 1013393156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN112644) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN112644) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2020-04-14 |