| NPI | 1740387653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN205580) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704115351) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2013-05-22 |