| NPI | 1104126036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN212157) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: TN 0000014768) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2010-12-21 |