| NPI | 1649272691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA R039856) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC R00079381) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2014-08-07 |