| NPI | 1609087972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN173488) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: GA RN173488) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN173488) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN173488) | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2011-10-28 |