| NPI | 1649864547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN249807) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN249807) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2023-09-14 |