| NPI | 1154750545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN225872) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA 225872) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 3207382) | |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2022-07-21 |