| NPI | 1568071777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN240089) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11006710) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-07-24 |