| NPI | 1710531413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN217674) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 23976) |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-06-22 |