| NPI | 1598134454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN178987) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP08167) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP08167) | |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2020-12-02 |