| NPI | 1083911630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN175608) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: DE LG0000541) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2013-02-27 |