| NPI | 1811408826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342659) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN181282) |
| 163W00000X Registered Nurse (Licence: GA RN181282) | |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2018-03-17 |