| NPI | 1700592722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN307381) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN307381) | |
| Enumeration Date | 2023-01-24 |
| Last Update Date | 2023-04-18 |