| NPI | 1679012256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: KY 3012534) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN252058) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IA H149472) | |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2025-09-20 |