| NPI | 1487026993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN275821) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 340136) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2022-05-10 |