| NPI | 1053618991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN129700) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN129700) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2016-05-12 |