| NPI | 1679981211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN183877) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN183877) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2017-05-04 |