| NPI | 1508485749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN336894) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-173915) |
| 363L00000X Nurse Practitioner (Licence: VT 101.0135406) | |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2025-12-31 |