| NPI | 1588966626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN188118) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 816877) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2012-05-07 |