| NPI | 1124258967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN213453) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: KS 14-60208-122) |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2011-12-21 |