| NPI | 1093139693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN160658) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA NCO-000001) |
| Enumeration Date | 2014-02-18 |
| Last Update Date | 2019-03-28 |