| NPI | 1538168398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R890697) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN139992) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2012-11-01 |