| NPI | 1104332543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN274399) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 23506) |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2024-01-25 |