| NPI | 1134118383 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN188449NP) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2214752) | 
| Enumeration Date | 2005-10-20 | 
| Last Update Date | 2019-01-25 |