| NPI | 1922453117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: GA 2019072427) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN196505) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN196505) | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2021-12-17 |