| NPI | 1073967055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN170626) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN170626) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2022-05-31 |