| NPI | 1164796488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN161641) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN161641) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN161641) | |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2020-04-20 |