| NPI | 1851087365 |
|---|---|
| Former Name | ASHLEY NICOLE SOUZA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN279230) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN279230) |
| Enumeration Date | 2023-04-17 |
| Last Update Date | 2024-02-19 |