| NPI | 1124530738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5023583) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN282741) |
| Enumeration Date | 2017-11-05 |
| Last Update Date | 2026-01-06 |