| NPI | 1053676536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN276955) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9234608) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 337130) | |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2019-11-25 |