| NPI | 1083107502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN235412) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN051783939) |
| 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: GA RN235412) | |
| Enumeration Date | 2018-06-09 |
| Last Update Date | 2021-01-26 |