| NPI | 1861746992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN176760) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18056) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2018-12-26 |