| NPI | 1407446446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN256760) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 632054) |
| 163W00000X Registered Nurse (Licence: GA RN256760) | |
| Enumeration Date | 2021-01-23 |
| Last Update Date | 2023-02-21 |