| NPI | 1669038303 |
|---|---|
| Former Name | MONIQUE ANTOINETTE PAULK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN170750) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN170750) |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2022-04-14 |