| NPI | 1265071534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN239197) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11005714) |
| 163W00000X Registered Nurse (Licence: FL RN9429902) | |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2025-10-10 |