| NPI | 1265183677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN263923) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2024-11-07 |