| NPI | 1083120463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN181635) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22001) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2024-06-21 |