| NPI | 1861965139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 22436) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN091688) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 22436) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: SC 26879) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 22436) | |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2022-01-10 |