| NPI | 1780030734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN 243044) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: GA RN243044) |
| Enumeration Date | 2016-05-09 |
| Last Update Date | 2019-01-03 |