| NPI | 1174038145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN216525) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA 216525) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN216525) | |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2022-03-22 |