| NPI | 1972591774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN114872) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN114872NP) |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2013-01-24 |