| NPI | 1679838098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN281462) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD AC001031) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2020-03-04 |