| NPI | 1558751206 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN194599) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9394344) | 
| Enumeration Date | 2015-02-03 | 
| Last Update Date | 2021-11-22 |