| NPI | 1366812562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: GA RN247227) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: PA SP015377) |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP015428) | |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2016-11-08 |