| NPI | 1700664372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN254308) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SC 30437) |
| 363L00000X Nurse Practitioner (Licence: GA RN254308) | |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN254308) | |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2025-06-30 |