| NPI | 1083859730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000014879) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN143968 NP) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2012-07-10 |