| NPI | 1063748788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN192280) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN192280) |
| Enumeration Date | 2009-10-30 |
| Last Update Date | 2020-09-22 |