| NPI | 1467616888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN222652) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-083300) |
| 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: AL 1-083300) | |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2012-08-09 |