| NPI | 1184077174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN288761) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 20342) |
| Enumeration Date | 2016-07-14 |
| Last Update Date | 2019-09-23 |