| NPI | 1992804447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN142933 NP) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN142933 NP) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2008-07-24 |