| NPI | 1750855417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN219738) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RN219738) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-02-15 |