| NPI | 1972805133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN230003) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN230003) |
| 363LF0000X Nurse Practitioner, Family (Licence: OK 83618) | |
| Enumeration Date | 2010-11-21 |
| Last Update Date | 2021-10-18 |