| NPI | 1578971552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN204468) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 18925) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2024-03-04 |