| NPI | 1457873549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN291788) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 197932) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 22279) | |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2020-02-05 |