| NPI | 1043644198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN297501) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 17797) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2024-08-05 |