| NPI | 1669763504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN221558) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000019520) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 731716) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2018-07-09 |