| NPI | 1235502188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA APRN-NP714667) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NH 055248-23) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5015848) | |
| Enumeration Date | 2015-11-01 |
| Last Update Date | 2026-04-14 |