| NPI | 1902505696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5020157) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA APRN224396) |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2026-01-28 |