| NPI | 1497058721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3008650) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN154964) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2014-07-10 |