| NPI | 1821536012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN195017) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN195917) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2017-02-07 |