| NPI | 1164005757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN207401) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN207401) |
| 163W00000X Registered Nurse (Licence: GA RN297401) | |
| 363L00000X Nurse Practitioner (Licence: GA RN207401) | |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2023-02-27 |