| NPI | 1487212304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R169521) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN241359) |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2020-09-09 |