| NPI | 1376839720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN197090) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 21778) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2013-06-25 |