| NPI | 1609218205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN162446) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-111870) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2020-11-20 |