| NPI | 1861850398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN273079) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL RN9326230) |
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC003147) | |
| 363LF0000X Nurse Practitioner, Family (Licence: FL F0716304) | |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2023-12-19 |