| NPI | 1063645497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN055775) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN055775 NP) |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2013-03-04 |