| NPI | 1053760512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9436133) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN225026) |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2016-07-18 |