| NPI | 1922259613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN234567) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 3010005) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 13630) | |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2022-07-21 |