| NPI | 1649584863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: GA F0707335) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN165564 NP) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2010-07-29 |