| NPI | 1790188605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN205498) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 2013016513) |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2018-03-21 |