NPI | 1982820551 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN104510 NP) |
Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: GA RN104510) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2014-03-03 |