| NPI | 1871978148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN170986) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN170986) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN170986) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2022-11-17 |