| NPI | 1679025829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN154476) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN154476) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 25640) | |
| Enumeration Date | 2016-11-03 |
| Last Update Date | 2022-01-03 |