| NPI | 1225321201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN213069) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-109860) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2013-01-01 |