| NPI | 1811249360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN290068) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005853) |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2021-08-10 |