| NPI | 1104441039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: GA RN157954) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN157954) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN157954) | |
| 363L00000X Nurse Practitioner (Licence: GA RN157954) | |
| Enumeration Date | 2020-06-16 |
| Last Update Date | 2025-10-16 |