| NPI | 1205114865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN135055) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN135055) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2019-07-02 |