| NPI | 1134373947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN175909) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2262527) |
| Enumeration Date | 2008-11-06 |
| Last Update Date | 2013-07-18 |