| NPI | 1629012331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN APN0000005515) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN10078 NP) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2016-03-23 |