| NPI | 1538662515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN293672) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ARNP9362476) |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2020-10-30 |