| NPI | 1588714554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 17592) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN086371NP) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2014-10-08 |