| NPI | 1124378054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: GA 225307) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: GA 225307) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2017-05-24 |