| NPI | 1700869773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN227177) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9228873) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2016-11-29 |