| NPI | 1063481224 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN089815)  | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA R089815)  | 
| Enumeration Date | 2006-03-17 | 
| Last Update Date | 2021-04-06 |