| NPI | 1487980710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 19363) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN152808) |
| Enumeration Date | 2009-10-21 |
| Last Update Date | 2018-08-10 |