| NPI | 1558962894 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN222944) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC APN.27926) | 
| Enumeration Date | 2020-11-03 | 
| Last Update Date | 2023-11-30 |