| NPI | 1891907069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN104182) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN104182) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN104182) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2011-12-15 |