| NPI | 1760822779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN187046) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: GA RN187046) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2014-04-08 |