| NPI | 1780076752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN196795) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19802) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2020-04-23 |