| NPI | 1073059804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN204131) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN204131) |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2025-03-20 |