| NPI | 1679094957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-131072) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 363LF0000X Nurse Practitioner, Family (Licence: GA NP002015) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-131072) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA NP002015) | |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2025-06-27 |