| NPI | 1861641839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA 225300) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 335696) |
| Enumeration Date | 2008-09-15 |
| Last Update Date | 2014-10-06 |