| NPI | 1124467873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN226373) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 178653) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 75913) | |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2015-05-15 |