| NPI | 1922716729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN240873) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH RN.411942) |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2025-03-31 |