| NPI | 1073670709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN101397) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO 178191) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2010-09-10 |