| NPI | 1265474407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN 109098) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 2594) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2012-11-26 |