| NPI | 1528244159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN139756) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 2889) |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2014-06-30 |