| NPI | 1154603678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-168009) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN176156) |
| Enumeration Date | 2011-09-10 |
| Last Update Date | 2018-09-26 |