| NPI | 1609262146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5010703) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN210698) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 20304) | |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2026-01-06 |