| NPI | 1548523418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16707) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN197890) |
| Enumeration Date | 2012-06-16 |
| Last Update Date | 2016-01-25 |