| NPI | 1790486363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA RN190933) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 695061) |
| 163W00000X Registered Nurse (Licence: GA RN190933) | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2024-11-18 |