| NPI | 1639433022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5005665) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN143854) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 158515) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5005665) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2021-10-03 |