| NPI | 1649787102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN189589) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN189589) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN189589) | |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2025-11-13 |