| NPI | 1326300617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN185501) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006781) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2019-06-06 |