| NPI | 1700456159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN269883) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 347782) |
| Enumeration Date | 2021-06-28 |
| Last Update Date | 2024-10-21 |