| NPI | 1801085790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN157897NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 157897) |
| 363LF0000X Nurse Practitioner Family (Licence: GA RN157897) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2012-07-27 |