| NPI | 1699054353 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN171232) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9316353) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 800015) | |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2011-08-12 |