| NPI | 1407048887 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN159396) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN159396) |
| 163W00000X Registered Nurse (Licence: GA RN159396) | |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2010-05-26 |