| NPI | 1669923157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN334871)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 9427718)  | 
| 163W00000X Registered Nurse (Licence: TX 702724)  | |
| Enumeration Date | 2016-10-19 | 
| Last Update Date | 2025-02-13 |