| NPI | 1861117129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN315630) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: GA RN315630) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2024-07-29 |