| NPI | 1265882542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN128814) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC APN.19704 APRN) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN128814) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: SC APN.19704 APRN) | |
| Enumeration Date | 2016-06-16 |
| Last Update Date | 2016-06-16 |