| NPI | 1922316405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA APRN-NP316853) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 66369) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71010054A) | |
| Enumeration Date | 2010-09-18 |
| Last Update Date | 2025-10-13 |