| NPI | 1275918781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN218849) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 218849) |
| Enumeration Date | 2015-07-26 |
| Last Update Date | 2018-07-13 |