| NPI | 1639501075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN199840) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN199840) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 17792) | |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2025-08-22 |