| NPI | 1417145939 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5005997) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN093611) | 
| Enumeration Date | 2007-10-10 | 
| Last Update Date | 2015-03-17 |