| NPI | 1588015473 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA APRN-NP217213) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN217213) | 
| Enumeration Date | 2016-06-22 | 
| Last Update Date | 2025-10-30 |