| NPI | 1407224819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN154719) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 19649) |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2016-03-22 |