| NPI | 1124729561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN240385) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN240385) |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-03-13 |