| NPI | 1871524116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN217541) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 722024) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2011-11-10 |