| NPI | 1104852144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP07717) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN113883) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2014-05-14 |