| NPI | 1033378203 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R188012)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN132008)  | 
| Enumeration Date | 2008-06-03 | 
| Last Update Date | 2025-09-02 |