| NPI | 1972911899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN209751) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 18700) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-10-09 |