| NPI | 1265615959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN166815) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 5387P) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2014-07-02 |