| NPI | 1497904643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN 214873) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024167986) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2012-01-25 |