| NPI | 1053649657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: GA RN159091) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: FL ARNP9229224) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN159091) | |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2018-06-05 |