| NPI | 1588383574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 26923) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN217787) |
| Enumeration Date | 2022-08-24 |
| Last Update Date | 2024-04-12 |