| NPI | 1184075012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN240475) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: GA RN240475) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2016-11-01 |