| NPI | 1831638006 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN189763) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN189763) | 
| Enumeration Date | 2017-02-21 | 
| Last Update Date | 2025-02-19 |