| NPI | 1457755365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07962) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN221811) |
| Enumeration Date | 2014-10-21 |
| Last Update Date | 2017-01-20 |