| NPI | 1518376482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN198713) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18989) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-08-05 |