| NPI | 1720450380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN256506) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5023706) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F356778) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024195972) | |
| 363LF0000X Nurse Practitioner, Family (Licence: SC APN.31446) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ15534600) | |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2026-03-04 |