| NPI | 1396195301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN192568) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN192568) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN192568) | |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2020-03-12 |