| NPI | 1093180473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN132888) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: GA RN132888) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2021-02-04 |