| NPI | 1972545119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 039500) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN154383) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2017-02-27 |