| NPI | 1790298222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN212830) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA RN212830) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2025-10-13 |