| NPI | 1700254364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN224123) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN 224123) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2019-12-05 |