| NPI | 1083237069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN224670) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RN224670) |
| Enumeration Date | 2020-05-25 |
| Last Update Date | 2023-06-06 |