| NPI | 1699204966 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9358703)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN274415)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9358703)  | |
| Enumeration Date | 2017-06-08 | 
| Last Update Date | 2022-09-12 |