| NPI | 1912252792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN164616) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN164616) |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2021-11-15 |