| NPI | 1407147754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN199099) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN577772) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 336505) | |
| 163W00000X Registered Nurse (Licence: NY RN595239) | |
| Enumeration Date | 2011-04-20 |
| Last Update Date | 2022-04-04 |