| NPI | 1205207388 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN161105) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MS R865978) |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2017-01-16 |