| NPI | 1922503622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN185371) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA Fo1180184) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2021-08-27 |