| NPI | 1306502083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: GA RN302027) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11016170) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: FL APRN11016170) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: GA RN302027) | |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2024-03-21 |