| NPI | 1538417548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN160040) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 214450) |
| 363L00000X Nurse Practitioner (Licence: GA RN160040) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC APN.17989 RX) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: SC APN.17989 RX) | |
| Enumeration Date | 2012-08-22 |
| Last Update Date | 2024-07-02 |