| NPI | 1124148473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN044396) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 231766) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2011-08-15 |