| NPI | 1790964880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN171089) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN APN12937) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2012-06-18 |