| NPI | 1104051168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN112304) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN112304) |
| Enumeration Date | 2009-05-20 |
| Last Update Date | 2019-06-14 |