| NPI | 1992041859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN240365) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008961) |
| Enumeration Date | 2012-12-21 |
| Last Update Date | 2017-02-13 |