| NPI | 1790959708 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC APN.1874 RX) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN169008NP) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2013-08-27 |