| NPI | 1740466622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN113689) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN113689) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2015-07-25 |