| NPI | 1154637874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 18102) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN173610 NP) |
| Enumeration Date | 2010-08-19 |
| Last Update Date | 2019-06-11 |