| NPI | 1326582107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: GA RN241516) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: TN 21264) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |