| NPI | 1528310794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN225977) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 745974) |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2013-06-26 |