| NPI | 1386124212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN302410) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-143445) |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2021-06-04 |