| NPI | 1205293230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN202908) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN202908) |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |