| NPI | 1063117398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN278675) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN278675) |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2025-01-15 |