| NPI | 1427580596 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN220104) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC APN.22129) | 
| Enumeration Date | 2017-03-29 | 
| Last Update Date | 2022-05-05 |