| NPI | 1750365979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN206803) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN206803) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN206803) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2022-09-30 |