| NPI | 1659819811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN267705) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL F1216219) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-10-16 |