| NPI | 1609846864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AL 1-051443) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN176817 NP) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2012-01-30 |