| NPI | 1376828087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN229466) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005357) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2019-05-06 |