| NPI | 1063141968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN182852) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN182852) |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2023-02-20 |