| NPI | 1639276751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN103949NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 3114) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2022-05-05 |