| NPI | 1114382397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN201420) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9422645) |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2020-08-18 |