| NPI | 1487138541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11004535) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN213699) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2025-09-22 |