| NPI | 1073069225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN215481) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 21615) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-10-23 |