| NPI | 1699115030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN178980) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NH 067725-23) |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2016-05-10 |