| NPI | 1942634175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN163623) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 840805) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2020-04-29 |