| NPI | 1649493537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN161498) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN161489) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN161498) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2018-06-26 |