| NPI | 1023566387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN297931) |
| Additional Taxonomies | 146M00000X Emergency Medical Technician, Intermediate (Licence: GA I-40267) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002731) | |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2022-02-21 |