| NPI | 1942584982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN195292) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: SC 4488) |
| Enumeration Date | 2011-10-10 |
| Last Update Date | 2013-10-02 |