| NPI | 1063696185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN271274) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 13094) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2019-07-17 |