| NPI | 1104462571 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN245120) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN245120) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2021-12-23 |