| NPI | 1639767007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN232902) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC BITT-1C6H9) |
| Enumeration Date | 2021-01-01 |
| Last Update Date | 2022-08-29 |