| NPI | 1851735583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-111601) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN228788) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-10-22 |