| NPI | 1952591034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN051705) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 188439) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2007-07-26 |