| NPI | 1114642980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN265323) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC APN26652) |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2024-06-28 |