| NPI | 1205486339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN311503) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-134274) |
| 363LF0000X Nurse Practitioner, Family (Licence: AL 1-134274) | |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2023-02-08 |