| NPI | 1124061700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN211812) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN211812) |
| 207Q00000X Family Medicine (Licence: GA RN211812) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: GA RN211812) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: FL APRN9331191) | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2024-06-14 |