| NPI | 1326633421 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN236317) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 22222222) | 
| Enumeration Date | 2021-03-02 | 
| Last Update Date | 2021-03-02 |