| NPI | 1164187977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11011972) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA GAA-NP003911) |
| Enumeration Date | 2021-11-05 |
| Last Update Date | 2025-08-06 |