| NPI | 1972713790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 036987) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP3364212) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2012-05-29 |