| NPI | 1154719540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN135482) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 135482) |
| Enumeration Date | 2015-01-07 |
| Last Update Date | 2018-03-17 |