| NPI | 1740936863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN310434) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 302528) |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-06-10 |