| NPI | 1639804594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA LPN035931) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 035931) |
| 363L00000X Nurse Practitioner (Licence: GA RN035931) | |
| Enumeration Date | 2022-07-23 |
| Last Update Date | 2023-08-29 |