| NPI | 1669491213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN125285) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 2722) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-03-17 |