| NPI | 1265766802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL ARNP9462934) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA 189815) |
| 363L00000X Nurse Practitioner (Licence: TN 14389) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2018-03-17 |