| NPI | 1639416126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA rn148404) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN148404) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2022-09-03 |