| NPI | 1104296599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-129614) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN221321) |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2017-05-04 |