| NPI | 1790773273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN205309) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP2849912) |
| 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: FL ARNP2849912) | |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2010-06-07 |