| NPI | 1215170188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN9232396) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 9232396) |
| 363L00000X Nurse Practitioner (Licence: GA RN259890) | |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2021-04-08 |