| NPI | 1619869112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN308169) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN308169) |
| Enumeration Date | 2025-07-18 |
| Last Update Date | 2025-08-27 |