| NPI | 1013384577 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R859652) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN24693) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 199994) | |
| Enumeration Date | 2015-08-31 |
| Last Update Date | 2016-12-09 |