| NPI | 1215281076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 17065) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN225095) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2016-05-11 |