| NPI | 1821457615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN170227) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA RN170227) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704241199) | |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2019-04-17 |