| NPI | 1003815523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA R100155) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 079281) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 2778862) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2010-09-15 |