| NPI | 1609952688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN153018) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: LA RN 119790 AP05291) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2015-12-07 |