| NPI | 1174602882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 17924) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ NN59255) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA 256036) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2016-08-12 |