| NPI | 1578264578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA rn331484) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024258) |
| 363L00000X Nurse Practitioner (Licence: FL APRN11024258) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11024258) | |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2025-11-06 |