| NPI | 1245430701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN 160612 NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209005942) |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2015-03-06 |