| NPI | 1710127261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN222649) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-077179) |
| Enumeration Date | 2009-02-24 |
| Last Update Date | 2012-09-07 |