| NPI | 1275257388 |
|---|---|
| Former Name | BERKELEY FAYE BOLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN281144) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2023-09-07 |