| NPI | 1467074203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN281132) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN281132) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN281132) | |
| Enumeration Date | 2020-05-14 |
| Last Update Date | 2023-02-08 |