| NPI | 1073549085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 3084) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN107264) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2014-07-05 |