| NPI | 1245343896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN106393) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-067853) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2007-07-08 |