| NPI | 1740749449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN282171) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 25551) |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2022-06-28 |