| NPI | 1861899312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN235059) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19468) |
| Enumeration Date | 2014-11-28 |
| Last Update Date | 2018-05-01 |