| NPI | 1720122187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA rn333463) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL arnp1538682) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1099380) | |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2025-01-27 |