| NPI | 1023726544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN207439) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN207439) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95023288) | |
| 163W00000X Registered Nurse (Licence: CA 95307896) | |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2024-03-05 |