| NPI | 1164720090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN171108) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN171108) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2020-08-19 |