| NPI | 1730869298 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN293810)  | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN293810)  | 
| Enumeration Date | 2023-07-20 | 
| Last Update Date | 2023-07-27 |