| NPI | 1003905803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA-12061-NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN186495) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2013-03-19 |