| NPI | 1538398664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN149121) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 3966) |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2021-05-13 |