| NPI | 1700456159 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA APRN-NP269883) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 347782) | 
| Enumeration Date | 2021-06-28 | 
| Last Update Date | 2025-10-29 |