| NPI | 1629246038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN237921) |
| Additional Taxonomies | 163WG0100X Registered Nurse, Gastroenterology (Licence: TN 137603) |
| 363L00000X Nurse Practitioner (Licence: TN 11839) | |
| 363L00000X Nurse Practitioner (Licence: TN APN0000011839) | |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2014-06-06 |