| NPI | 1265955652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN269847) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN269847) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2022-12-28 |