| NPI | 1881310449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA 255804) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NE 115122) |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2025-03-13 |