| NPI | 1104068840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20287) |
| Additional Taxonomies | 163WC0200X Registered Nurse, Critical Care Medicine (Licence: GA RN185304) |
| 225200000X Physical Therapy Assistant (Licence: SC PTA1521) | |
| 225200000X Physical Therapy Assistant (Licence: GA PTA002269) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN185304) | |
| Enumeration Date | 2009-03-26 |
| Last Update Date | 2022-11-03 |