| NPI | 1750640363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA NP712978) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 578272-1) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2026-03-17 |