| NPI | 1649424284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5009671) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN157084) |
| Enumeration Date | 2008-11-10 |
| Last Update Date | 2021-04-09 |