| NPI | 1407396609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: GA RN154981) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN154981) |
| Enumeration Date | 2017-03-07 |
| Last Update Date | 2018-03-17 |