| NPI | 1194042036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN286041) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: NC 234600) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5010499) | |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2025-03-12 |