| NPI | 1013576016 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN293634) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 22920) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2020-05-15 |