| NPI | 1912069121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004071) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN117749NP) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2021-04-01 |