| NPI | 1639729759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN254966) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN254966) |
| 363LF0000X Nurse Practitioner, Family (Licence: SC 23309) | |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2024-02-29 |