| NPI | 1790049245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16834) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN218891) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2012-12-20 |