| NPI | 1316409451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN230963) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN230963) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2020-02-19 |