| NPI | 1134632391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN272064) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 217421) |
| 163W00000X Registered Nurse (Licence: GA RN272064) | |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |