| NPI | 1518119841 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN106501)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN106501)  | 
| Enumeration Date | 2008-10-17 | 
| Last Update Date | 2022-07-21 |