| NPI | 1699255711 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN337856)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY f344120-1)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.022814)  | |
| Enumeration Date | 2018-08-17 | 
| Last Update Date | 2025-08-19 |