| NPI | 1659103695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN299106) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL aprn11034855) |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |