| NPI | 1497120414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: GA RN205755) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: GA RN205755) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2020-10-14 |