| NPI | 1871570143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN082935) |
| Additional Taxonomies | 367H00000X Anesthesiologist Assistant (Licence: TX 633458) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2010-11-19 |