| NPI | 1104385863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN297387) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9391204) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN297387) | |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2023-10-09 |