| NPI | 1245580471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN196442) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN196442) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2018-01-08 |