| NPI | 1467015818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 310130) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN219414) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN219414) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN219414) | |
| Enumeration Date | 2019-04-20 |
| Last Update Date | 2025-06-09 |