| NPI | 1093944316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN217049) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN217049) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 3887) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2025-10-27 |