| NPI | 1649767310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN162502) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA NCO-000-001) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-06-16 |