| NPI | 1457655797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5007968) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD R178088) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN230719) | |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2016-03-09 |