| NPI | 1467748830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN225668) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: SC 17501) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2014-12-11 |