| NPI | 1366408130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN085787) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN085787) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2009-09-18 |