| NPI | 1720116163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN118947NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 118947) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2011-10-06 |