| NPI | 1003445297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN240872) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 1105457) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2022-03-09 |