| NPI | 1770768848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN127665) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN127665) |
| 163WG0000X Registered Nurse General Practice (Licence: GA RN127665) | |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2014-02-17 |