| NPI | 1194089920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN194038) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN194038) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2014-02-25 |