| NPI | 1902209505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5008529) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN205991) |
| Enumeration Date | 2014-09-27 |
| Last Update Date | 2016-05-12 |