| NPI | 1114212115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN193864NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 193864) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2016-12-14 |