| NPI | 1164861274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN238441) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 238441) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2021-05-12 |