| NPI | 1912529819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN249619) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NC 5013086) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2022-02-03 |