| NPI | 1528001765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN149515) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TN 20017) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-11-08 |