| NPI | 1295729945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN221894) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY RN-317526-1) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2020-10-07 |