| NPI | 1063762870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN219785) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA RN219785) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2020-12-03 |