| NPI | 1194188797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11014991) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN226798) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2023-08-22 |