| NPI | 1538577416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP9599) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN239541) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN239541) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN239541) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: AZ AP9599) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP9599) | |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2017-01-05 |