| NPI | 1295157196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16964) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN216536) |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2017-01-18 |