| NPI | 1376517037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN170840) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 254738) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2012-12-28 |