| NPI | 1366499808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN276993) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NH 00000-01) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2020-09-21 |