| NPI | 1578604609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 3303772) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN102612 NP) |
| Enumeration Date | 2007-02-10 |
| Last Update Date | 2016-02-12 |